Lungworm case - current advice and prognosis?

Re: Lungworm case - current advice and prognosis?

Virginia Campbell — Sat, 10 May 2014 09:03:29 GMT

Nice one!

Re: Lungworm case - current advice and prognosis?

Hannah Wynne Richards — Sat, 10 May 2014 08:26:23 GMT

Brilliant news ! Congrats !

Wynne

Re: Lungworm case - current advice and prognosis?

Beats — Fri, 09 May 2014 19:33:36 GMT

Well, case update for anyone interested:

Massively better given was pretty much quadriplegic prior to treatment. Reasonably rapid improvement and got home for nursing care only within about 3 days I think it was.

Saw back this week and can run, but uncoordinated and ataxic. Also has fits of scratching maniacly at neck (demonstrated to me during consultation, kind of reminiscent of that "classic" neck-scratching in CKCS with syringomyelia that I rarely see but gather is associated with dysaesthesia or paraesthesia or something.

Gave more fenbendazole and milbemycin and trying some gabapentin to see if helps with neck-scrathicng episodes at all.

I'm hoping there'll stil be improvement yet over enxt 6wks or so, but certainly done well and much more rapid and complete than I would hav expected for a "traditional" cervical disc lesion prognosis-wise.

Re: Lungworm case - current advice and prognosis?

Hannah Wynne Richards — Sun, 20 Apr 2014 09:47:18 GMT

Not seen them,and in Swansea, if it hasn't been treated, it's got it. We're the lungworm capital of Great Britain.

Wynne

Re: Lungworm case - current advice and prognosis?

Tom Ward — Fri, 18 Apr 2014 13:49:24 GMT

[quote user="Hannah Wynne Richards"]

My favourite is the alternate month milbemax and panacur regime. Although inadequate to treat a clinical case, I've found 7 days treatment alternate months to be brilliant at preventing disease. I know that theoretically it should be every 7 weeks, but I get good compliance if I simplify things, and say alternate months.

Wynne

[/quote]

How do you know that is brilliant at presenting disease? Just not seen any cases that have been on this regime?

Re: Lungworm case - current advice and prognosis?

ruths — Fri, 18 Apr 2014 12:14:21 GMT

We've had lungworm for some time- I usually advise monthly advocate as for ages this was the only licensed product. Now I advise either milbemax or advocate We treated the clinical cases with advocate and sometimes fenbendazole too- out of 20-30 cases I've seen i found one still infected/ reinfected after 4 weeks and gave that another advocate and retested after 10 days and it was clinically well and negative on a bauhermanns test. Pre advocate, we used fenbendazole, which worked just fine too. We have lost some dogs on both advocate and panacur but I have blamed the severity Of the disease, not the drug tbh.

Re: Lungworm case - current advice and prognosis?

Hannah Wynne Richards — Fri, 18 Apr 2014 10:53:30 GMT

That's my favourite - it's what I give my dog

Wynne

Re: Lungworm case - current advice and prognosis?

katja wagner — Thu, 17 Apr 2014 23:34:54 GMT

[quote user="Hannah Wynne Richards"]

Only treat earlier, but it sounds as though this was the owner's fault, not your's.

Wynne

[/quote]

yes ,I wish they had come back earlier. I only work nights and was in the middle of a caesarian when the nurse did a quick check on the inpatients and noticed the seizure,had to split myself in half which was no fun. scared the hell out of me and I tested my own dog the next day who is negative and now on monthly advocate but might change this tx regime to panacur/milbemax.

katja

Re: Lungworm case - current advice and prognosis?

Beats — Thu, 17 Apr 2014 19:06:18 GMT

Thanks soooo much for all the advice and shared experiences and ideas so far - really helpful.

It seems like there is quite a few of us getting to grips with this emerging condition as it spreads to our own areas (in my case having been quite skeptical of the hype in preceding years... ) .

I personally really want to strike a sensible balance between not scare-mongering and advising sensible precautions - I'm still not just sure exactly how best to go about that!

I normally recommend milbemax 4 times a year for toxocara anyway, so perhaps I don't have to change advice based on emergence of lungworm in my area?? But then, having had a recent baby I'm now worming my own dog monthly and wondering if I should be considering that as a recommendation to others as well? Arrrggghhh... so confusing, especially with all new flea treatments that have come on market to decide what simplest effective and not-over-the-top general parasite recommendation for dogs could be?!

Here's the lateral chest xray from the case I had that started the thread in case anyone's interested, I didn't really see any changes and was no coughing reported or dyspnoea etc in the history or initial presentation:

Re: Lungworm case - current advice and prognosis?

John Flynn — Thu, 17 Apr 2014 18:05:25 GMT

On the prevention note, I've found varying recommendations suggested.

Jon Wray in a recent UKVet discussion article (Sept 2013) said:

"I usually recommend after recovery, that all dogs in the household are treated with an adulticide every 3 months, though this represents a fairly arbitrary figure based on practicality/compliance of owners rather than matching the likely pre-patent period of the parasite."

I guess, I'm wondering if I should be recommending more routine treatment to dogs/puppies in the area rather than just when disease is present. Always a hard call, but having seen 2 nasty cases now (one of which is now dead), both contracted locally, I reckon that prevention would be better than treatment.

Drug-wise, I can see a few options:

milbemycin containing oral drugs (milbemax, trifexis, program plus)
moxidectin topically (advocate)
fenbendazole (cheap, but I'm confused as to what would recommend re dose and frequency?)

And this prevention could be done every 1 month (based on prepatent period) or 3 months (based on risk-based assessment and expected compliance). This sounds a bit like the arguments for how often to recommend worming for toxocara.

Are these roughly the conclusions others are reaching?

Do folks who have had this parasite endemic in their area recommend routine prophylaxis to new puppy owners for instance? If so, what recommendation are you making?

Re: Lungworm case - current advice and prognosis?

Martin Atkinson — Thu, 17 Apr 2014 17:42:58 GMT

Beats. I always suspect lungworm with any odd neuro case with an anaemia or bleeding cases as that is always how they have presented to me, when asked the owners may then say the dog had a soft cough as well but that didn't worry them. Anjya touched on this but if you took a a thoracic X-ray you should see the characteristic patches of fluffy alveolar pattern. I don't have Angiotest and have relied on faecal samples for diagnosis but would always give a preemptive course of Panacur anyway.

Re: Lungworm case - current advice and prognosis?

Hannah Wynne Richards — Thu, 17 Apr 2014 17:28:17 GMT

Bob Actually we've got 2 people asking for advice. Katja is the 2nd, and did use panacur, so I read her posting correctly, you didn't.

Wynne

Re: Lungworm case - current advice and prognosis?

Hannah Wynne Richards — Thu, 17 Apr 2014 17:26:07 GMT

Agree with that - sorry I didn't read your posting properly. Panacur is definitely the best treatment for clinical cases.

Wynne

Re: Lungworm case - current advice and prognosis?

Bob Russell — Thu, 17 Apr 2014 17:04:50 GMT

[quote user="Hannah Wynne Richards"]

Only treat earlier, but it sounds as though this was the owner's fault, not your's.

Wynne

[/quote]

If you relied on Advocate to treat perhaps next time use Fenbendazole as well! I am deeply suspicious of any product that claims 100% efficacy!!

Re: Lungworm case - current advice and prognosis?

Hannah Wynne Richards — Thu, 17 Apr 2014 16:35:07 GMT

Only treat earlier, but it sounds as though this was the owner's fault, not your's.

Wynne

Re: Lungworm case - current advice and prognosis?

katja wagner — Thu, 17 Apr 2014 16:14:48 GMT

recently had a confirmed case tested positive on the snap test,dog presented about a month ago with mild increased respiratory effort and occ.cough,chest x-rays had been adviced but client waited a month before they came back with a very lethargic dog,thorax x-rays showed alveolar-interstitial lung pattern tx of iv steroids,antibiosis and panacur was started ,dog went into status epilepticus a few hours later and died.suspect brain haemorrage. any ideas how to prevent this?

katja

Re: Lungworm case - current advice and prognosis?

CatherineThomas — Thu, 17 Apr 2014 12:21:35 GMT

I used the Seresto collar on my dog and she didn't seem to have any adverse reaction to it. We don't have that many ticks round here but we went on holiday to Scotland last year and everyone kept telling us that there were lots of ticks in the area. She hasn't had a single tick since the collar went on.

Re: Lungworm case - current advice and prognosis?

Bob Russell — Thu, 17 Apr 2014 10:56:05 GMT

[quote user="karen jones"]I have but made my dog very sleepy after about a week, wasn't her usual bouncy self so took it off, shame as would be great for me as we have lots of ticks. Just given them a comfortis this time but will need to use something as well for ticks

[/quote]

Try it again, Karen! See if the dog gets sleepy again!

We have sold hundreds and the main side effect is general, mild pruritus especially for the first couple of weeks. Don't think this is on the data sheet but we have had it reported a lot!

Home is in the middle of nowhere in the New Forest so tick levels are through the roof. Not had a single tick on our dogs or cats since March 2012!

I will only have confidence in Advocate when independent specialists start to recommend and use it for treatment. We use Milbemax for prevention (low risk area but is present) but fenbendazole for treatment. The idea that 28 days application prevents but monthly does not seems to be clutching at straws. 28 days would seem correct for flea control with imidacloprid.

Re: Lungworm case - current advice and prognosis?

karen jones — Thu, 17 Apr 2014 08:02:53 GMT

I have but made my dog very sleepy after about a week, wasn't her usual bouncy self so took it off, shame as would be great for me as we have lots of ticks. Just given them a comfortis this time but will need to use something as well for ticks

Re: Lungworm case - current advice and prognosis?

Michael Woodhouse — Thu, 17 Apr 2014 00:27:16 GMT

[quote user="Chris Reichmann"]To prevent lungworm Advocate has to be applies every 28 days and not monthly as I have told owners before. We had a lungworm case (haemorrhage post spey) who's owner applied Advocate once a month. On raising this with Bayer we learnt that it has to be applied every 28 days![/quote]

That's just their 'get out of jail free card'.

Also (did you ever watch, House?) people lie. How many insist they are applying the Frontline monthly, buying from you, but last had a 3 pack 9 months ago?

Personally I am useless at remembering to de-flea out dogs - usually do them when they start scratching......

(anyone tried the Seresto collars?)

Re: Lungworm case - current advice and prognosis?

Hannah Wynne Richards — Wed, 16 Apr 2014 17:07:42 GMT

Wynne

Re: Lungworm case - current advice and prognosis?

Thomas Johnson — Wed, 16 Apr 2014 16:35:18 GMT

[quote user="Chris Reichmann"]

To prevent lungworm Advocate has to be applies every 28 days and not monthly as I have told owners before. We had a lungworm case (haemorrhage post spey) who's owner applied Advocate once a month. On raising this with Bayer we learnt that it has to be applied every 28 days!

[/quote]

I have to admit I've always found this slightly confusing, as the license claims treatment from a single application, I can't see how a 2-3 day gap before the next treatment is going to make any difference.

My view would be that no treatment is effective in 100% of cases however often you apply it.

Re: Lungworm case - current advice and prognosis?

Chris Reichmann — Wed, 16 Apr 2014 16:14:50 GMT

[quote user="Hannah Wynne Richards"]

Prevention:

a) Monthly Advocate

[/quote]

Re: Lungworm case - current advice and prognosis?

Thomas Johnson — Wed, 16 Apr 2014 15:19:51 GMT

[quote user="Hannah Wynne Richards"]

The reason it's so prevalent here is that some 10/15 years ago, we none of us expected a disease which the textbooks told us occurred in "the south of France, and southern states of the USA".

By the time we realised why our pneumonias of unknown origin, or warfarin poisonings, or weird neuro cases kept dying,the disease was well established.

[/quote]

The trouble is that foxes can be infected with angiostrongylus, so if we'd known about it sooner we may have been able to slow its spread, but we wouldn't have been able to stop it.

Re: Lungworm case - current advice and prognosis?

Hannah Wynne Richards — Wed, 16 Apr 2014 13:03:04 GMT

The reason it's so prevalent here is that some 10/15 years ago, we none of us expected a disease which the textbooks told us occurred in "the south of France, and southern states of the USA".

By the time we realised why our pneumonias of unknown origin, or warfarin poisonings, or weird neuro cases kept dying,the disease was well established.

Wynne